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II1 SERVICE WORK ruin Cie a n Te ch ORDER Environmental Inc. 288728 � I 5820 Martin Road • Irwindale, CA 91706 Phone: 626-812-7200 WASTE RECYCLING RECEIPT !dame: i f r' , Customer Purchase Order# c t ' c T - `*V` Sales Represent0ve Address: f i! fir t Phone# �I City. State,Zip. Federal Manifest#: ,J� c r1 EPA ID #: w et�_�� LLl1 L r�^ CHARGE L QUANTITY UNITS U.S.f]OT DESCRIPTION GAL• LASED Olt.-NODI RCRA HAZARDOUS WASTE,LIQUID CA WASTE CODE 22i GAL. USED ANTI-FREEZE-NON RCRA HAZARDOUS WASTE.LIQUID J CA WASTE CODE 134 01LY WATER FROM US€D PARTS WASH SOLUTION- C'A'L• NON-RCRA HAZARDOUS WASTE,LIQUID, CA WASTE CODE 134 OIL's MkLi ••, c F �� U DRUM(SI DRAINED USED OIL AND GAS FILTERS �1! w m TOTAL } d W _e;Industrial vd W The at>Ova used Oil Is- 9a,Lubrtcaling al-_ -- sof 1.5'1G CL ACCOUNT STATUS. S )C-O.D. t }4PEN ACCOUNT it open Aecounl•psyment is due reit 30 days ar fa ftnenca CIt#r9 per mit sRPIY U g{NERATOR'S NOTIFICATION AND CENTIFICArl9II; Any used ell Thal the transp4ner receives Irpm the the Fe tOl l A i Iberehyrted ar A sertdled used is 1 mis rip reign• w IV that ;fawlully tlperahnq+n aOCerdance with a tiwrdous waste InIlMS perms issued purSWnl to the markedAand Ila6ebEe6 And�n IM iNlre,pects�wtsp�oper Odndltgtan i � mem are Tully and aCCurately described 30ove by the proper shlpptng Herne 2nd are cl.tsstlled paCkgned. IOr transport by h,gnway acCardsnq ld applrrabk naUbnai regulations Ab relEvanl trNbrnial10n regardrnq known or suSpeGled natirdsbssouated with Iters waste has been � Q 'I di s Angeles Cdu sl 1 declare 10 4perrteti(y Thal the IOrm and an rmiu@ ands IneCET ere3�y ed in the declare hatAWIM lthe C01 enta dl this cons+4nment a e Tully as 01 ri d acjcuaa ely d SMI, cr bed a(S� 1 above by I"prgper shrppino name,and are CiasSliied.packaged,marked.Arid Iabeleoipiasard,irid are In all respects m 4,9per hisr nsi lOr lranspo eneraparl terms tb}1 1 �y ; cabl8 Snd nahondt governmental rgqulatiorls. II Export shlpnirnt and I am the primary Expeller.1 certify that the CdMenls O1 Inrs ad&ro qu nl C genal to rlork Of TIM fI aTt2Ghtd EPA knvwladgment dl Gonsenl I Certify that the waste minlmtyAtm slatament Identt}ad In 40 GFR 25in Ir aI{d I accurate c r Ie dewnlations of quantity y 2m a evanlla 5mallrmaLdn regard ng klnowil OF 50sPOCte0 haiaTds aSSNIhted w,lh thehwasts haS s arid.111 Ron disclosed ichLd e 1 also its nack+,0% s o trial 30A t a puread d agreee she rermis d, l this corm.hath(rant and hao Slgner guarantees lite Payment clearffnh,nvotm In aCCOrdanse wtlrl the standard leans 01 Net 34 It a purchase order K not issued, rme0 guarantees that any invoices presenlK mil be pard Promptly. Prdmpl payment is defined as payment in accordan0e �! the empieva Autneruing the work to 0 wo � men!,e nor roni�ngenl� on pays t by a third gaily lmereal 4n past tlue aCc0unl9 vnH tie Charged at the Talo 4f with CIw%ch standard terms of 30 days Yh nice pay t 5 r riddDl until pakl.WAST,MATEItl Wgli;Vt APE DISCdVEREO T❑ MO DNFDRMIMG Wlll SE SIl&IECT TO AOPITIDNAL CHARGE *- y � � • �- y $Gt+1ATURE DATE= TypE OR PRINT FULL NAME 1! f cella teal 1 tlBve read and have the authorrty to hlnn IhB nlsO'ye Ilaied genaietor.Io 1fie terms ort the r8,reree irde of this kxnn. I heretly lY 1 � l Stale t�requires Thal you keep,his Recelptl'l31N oI Ladmg on file Ior no less,ban f 31 Years. + •. xtE'>fM f ¢ CleanTech Environmental Inc. l l .11h1tim I 2 5620 Martin Road _ 1, !n1 I^ a - • O Irwindale,CA 91706 DRI R' NAME=1'Y OA PRINT FULL NAME y EL EPA to#;CAL000330453 z AC f _ - ., — SIGNATURE DATE Truck. Unit ID No- ked box is the designated recycling IacilttY The chBc Henle a Environmental Services LLC ^I.+-Cieantech Environmental >♦ W Z K Pure Waterworks Crnshy 8 Overton g y� t610 W.17th Street 284 East Storey l5920 Martin Rd. I 8910 Rochester Ave. +1Lang Beach,CA 90813 Coolidge,AI 55128 Irwindale,CA 91706 v — Rancho Cucarnanga, EPA CAOt72B409019 EPA 0 AZD081705402 EPA+CAL004330453 U CA 91730 L*1 Ph 15201723-4167 Ph 1 626,'812.7200 i a. LL Ph P11 56Zg325445 909J47S 9492 1